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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419346
Report Date: 12/03/2019
Date Signed: 12/03/2019 01:55:10 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:CHILDREN'S COLL INC/HOPE MEMORIAL CDC, THEFACILITY NUMBER:
197419346
ADMINISTRATOR:BACH, ROCIOFACILITY TYPE:
850
ADDRESS:3401 SOUTH SOMERSET DRIVETELEPHONE:
(310) 733-4388
CITY:LOS ANGELESSTATE: CAZIP CODE:
90016
CAPACITY:30CENSUS: DATE:
12/03/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Jermaine Kyle TIME COMPLETED:
01:45 PM
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On 12/03/2019 at 12:05 PM, Licensing Program Analyst, Stella Gutierrez conducted a Case Management Visit for the purpose of a self reported incident that occurred at the facility on 11/20/2019 time unknown. LPA met with Director, Jermaine Kyle who guided LPA on a tour inside and out of the facility. LPA explained the reason for today’s visit.

CCLD/El Segundo received the Unusual Incident report on 11/21/2019 and LPA, Stella Gutierrez was assigned to the incident investigation on 11/26/2019. A telephone call was made to Director, Jermaine Kyle on 11/27/2019 and obtained a statement over the phone regarding the incident. Upon arrival to the facility LPA, Gutierrez observed the following.

There were 18 children present (napping) with 4 staff providing supervision and proper care. Facility is operating within capacity limitations. Children were napping on individual cots and had appropriate bedding. LPA did not observe any children left unattended in classrooms, playground or the bathrooms. All adults present at the facility have all obtained criminal background Clearance and are all associated with the facility. LPA, Gutierrez conducted interviews with Staff # 1, Staff # 2, Staff #3, Director and Child #2

Documents reviewed during today’s visit: Children’s attendance records for the month of November 2019, Childrens Roster, Employee attendance records for all staff providing care and supervision on 11/19/2019 and Staff Roster.

Based on observation, interviews and documents reviewed there are no deficiencies cited today. LPA, Gutierrez reminded all staff that its important to continue to 100% supervision of children while in care in all areas of the facility.

An exit interview was conducted with Director, Jermaine Kyle and a copy of this report and a Notice of Site visit was provided. LPA, informed Director that the notice of site visit must be posted for 30 days upon receipt.

SUPERVISOR'S NAME: Victor BautistaTELEPHONE: (424) 301-3008
LICENSING EVALUATOR NAME: Stella GutierrezTELEPHONE: (424) 301-3065
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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